Upon completion of clinical procedures, and occasionally during the procedure, a tissue access site is to be closed, either permanently or temporarily. For example, in some instances, it may be desirable to close a tissue wall puncture at least temporarily to monitor the patient's status or the effectiveness of the procedure performed. In doing so, a simple, quick, and effective means for closing or sealing a tissue puncture is desirable. Moreover, for temporary closure, it is further desirable for an easily removable sealing technique to allow simple removal prior to final closure of the puncture.
To reference as illustrative examples, cardiac surgery may utilize a conduit system, such as for use during procedures including, but not limited to, bypass, cardiac valve repair, cardiac valve replacement, attachment of a ventricular assist device, establishment of an apicoaortic conduit (“AAC”), and various combinations thereof. Intermediate conduit sealing may be called for during the procedure or thereafter. Such conduit systems can be used to create alternate outflow tracts in “off pump” procedures, which may effectively reduce and/or negate the detrimental effects of both cardio-pulmonary by-pass (“CPB”) and global cardiac ischemia, as well as avoiding vital areas of the heart, such as the conduction system, the native coronary arteries, and grafts from previous surgical revascularization. During a procedure utilizing a conduit system, a core or puncture is created through the tissue (e.g., the cardiac wall at or near the cardiac apex) and a conduit placed therethrough. The conduit thus provides access through the cardiac wall to the procedure site. In some instances, portions of the conduit may be removed and the cardiac tissue puncture is to be sealed or closed at least temporarily, such as for patient monitoring or during a change in procedure or instruments. It may be necessary for a surgeon to re-access the tissue, and for the conduit to be re-opened at the procedure site. Similar needs exist for procedures performed on other anatomical structures, and are not limited to cardiac procedures, such as gastric procedures requiring closure of the stomach and intestinal tissues to avoid gastro-intestinal drainage, prostate procedures to seal the prostrate during intervention, laparoscopic procedures to (temporarily or permanently) close trocar entry sites, and neurologic procedures to control drainage or to close access or wound sites near or within the cephalic cavity, for example.
Certain related devices and conduits have been previously described, such as those described in U.S. Pat. No. 7,846,123, which is incorporated by reference herein in its entirety. However, improved systems for closing and sealing a tissue puncture are desirable, which may optionally be utilized to provide temporary closure for later access.